National Provider Identifier
Mark Alexander Pettit
Mark Alexander Pettit is listed in the NPPES registry with a primary specialty of Emergency Medicine Physician in Rochester, NY and a listed phone number of (585) 922-4000.
Profile Overview
- NPI
- 1487911947
- Provider Type
- Individual
- Primary Specialty
- Emergency Medicine Physician
- Enumeration Date
- April 20, 2012
- Last Updated
- August 23, 2016
Practice Location
- 1425 Portland Avenue
- Rochester, NY 14621
Phone: (585) 922-4000
Mailing Address
- 1425 Portland Ave
- Rochester, NY 14621-3001
Specialties
- Emergency Medicine Physician (207P00000X)
Full Record
- NPI
- 1487911947
- Entity Type
- Individual
- Last Name
- Pettit
- First Name
- Mark
- Middle Name
- Alexander
- Mailing Street Address
- 1425 Portland Ave
- Mailing City
- Rochester
- Mailing State
- NY
- Mailing ZIP Code
- 14621-3001
- Mailing Country
- US
- Mailing Phone
- (585) 922-4000
- Practice Street Address
- 1425 Portland Avenue
- Practice City
- Rochester
- Practice State
- NY
- Practice ZIP Code
- 14621
- Practice Country
- US
- Practice Phone
- (585) 922-4000
- Enumeration Date
- April 20, 2012
- Last Updated
- August 23, 2016
- Sex
- Male
- Sole Proprietor
- No
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Emergency Medicine Physician (207P00000X)
- Other Identifiers
- 04239745 (NY)